Why are you interested in applying for the Leading in Community Certificate Program?*

Provide a brief biography including educational background, work experience, community leadership, and volunteer history. The biography should also include your personal goals for leadership and what you hope to gain from this program (300 word limit)*

You may also attach a resume.

Accepted file types: doc, txt, rtf, pdf, docx.

Are You Interested in applying for a Scholarship?*

Yes

No

To apply, please attach a statement concerning your financial need, involvement in the community and/or how you hope to benefit from your participation in LIC. (200 words)

Accepted file types: doc, txt, rtf, pdf, docx.

Would your organization be willing to financially contribute to your tuition for Leading in Community?*

Yes

No

Contact Person's Name*

FirstLast

Contact Person's Title*

Contact Person's Email*

Contact Person's Phone*

*

By checking this box you are affirming the accuracy of your statements contained within this application.